Activity Overview

Nurses play an essential role in optimizing outcomes for patients with hematologic disorders. This Medical Crossfire® educational activity, “Management of Adverse Events Associated with Therapies for Hematological Disorders: Nurses’ Perspective,” is designed to help nurses address clinically unmet needs in the management of adverse events associated with treatments for hematologic malignancies. Expert faculty will discuss the clinical relevance of timely identification and management of potential toxicities and address strategies to help anticipate problems that might adversely affect patients, thereby improving patient treatment adherence and outcomes. The essential role of oncology nurses in enhancing patient management in the context of the multidisciplinary team will also be reviewed.

Acknowledgment of Commercial Support

This activity is supported by educational grants from Ariad and Celgene Corporation.

Instructions For This Activity & Receiving Credit

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Each presentation may contain an interactive question(s). You may move forward through the presentation; however, you may not go back to change answers or review video files/content until you finish the presentation.

At the end of the activity, "educational content/video files" will be available for your reference.

In order to receive a CME/CE certificate, participants must complete the activity.

Complete the posttest and pass with a score of 70% or higher, complete the evaluation and then click on request for credit. Participants may immediately download a CME/CE certificate upon completion of these steps.

Target Audience

This educational activity is directed toward nurse practitioners, physician assistants, and nurses with an interest in the treatment of hematologic disorders.

The staff of Physicians' Education Resource®, LLC, have no relevant financial relationships with commercial interests to disclose.

Disclosure Policy and Resolution of Conflicts of Interest (COI)

It is the policy of PER® to ensure the fair balance, independence, objectivity, and scientific objectivity in all of our CME/CE activities. In accordance with ACCME guidelines, PER® requires everyone who is in a position to control the content of an educational activity, including spouses/partners, to disclose all relevant financial relationships with any commercial interest to participants as part of the activity planning process. PER® has implemented mechanisms to identify and resolve all conflicts of interest prior to release of this activity.

Off-Label Disclosure and Disclaimer

This CME/CE activity may or may not discuss investigational, unapproved, or off-label use of drugs. Participants are advised to consult prescribing information for any products discussed. The information provided in this CME/CE activity is for continuing medical and nursing education purposes only and is not meant to substitute for the independent clinical judgment of a physician or nurse relative to diagnostic, treatment, or management options for a specific patient’s medical condition.

The opinions expressed in the content are solely those of the individual faculty members and do not reflect those of Physicians’ Education Resource®, LLC, or any of the companies that provided commercial support for this activity.

The first of 3 PER Pulse™ Recaps from this Medical Crossfire® focuses on a panel discussion promoting awareness of adverse events associated with several different classes of treatments for hematologic malignancies. The faculty used a case presentation of a patient with multiple myeloma to address several commonly encountered treatment associated-toxicities, beginning with infusion reactions associated with monoclonal antibody therapies. The faculty offered several measures that could be taken to mitigate potential problems associated with an initial infusion of daratumumab.

The faculty also addressed adverse events seen with other classes of multiple myeloma therapies, including steroids, conventional chemotherapy, immunomodulatory drugs, proteasome inhibitors, and histone deacetylase inhibitors.

Steroids are very important in lymphoid and plasma cell malignancies, but require education regarding their effect on blood sugar, as well as the potential for sleep difficulties, gastritis, and other challenges.

Conventional cytotoxic chemotherapy approaches are still used for hematologic malignancies. Education regarding medication administration and side effects is important to optimize outcomes.

Immunomodulatory drugs are commonly used, and clinicians and patients alike need to be particularly mindful of potential for thrombosis, particularly when they are used in combination with steroids. There is also potential for myelosuppression, diarrhea, and neuropathy with these drugs.

The second of 3 PER Pulse™ Recaps from this Medical Crossfire® focuses on a panel discussion of strategies to stay ahead of treatment-related adverse events, focusing on a patient with chronic myeloid who is treated with tyrosine kinase inhibitor (TKI) therapy. The faculty offered the following perspectives:

It is imperative for nurses to be able to prepare patients for potential toxicities associated with TKIs, even second and third generation TKIs. Cardiovascular toxicities are quite common, and familiarity with different TKIs and their individual toxicities can help to tailor therapy. Data from frontline and second-line setting studies, such as PACE and ENESTnd, have established the prevalence of cardiovascular toxicities. It is important for cardiovascular assessment to take place with TKI therapy.

Myelosuppression also needs to be addressed with TKI therapy, as does the potential for hepatotoxicity and pancreatic toxicity, as well as fluid retention. Careful monitoring is also essential to mitigate toxicities associated with other classes of therapy.

The third of 3 PER Pulse™ Recaps from this Medical Crossfire® focuses on a panel discussion of management of treatment-related adverse events in special patient populations as well as the vital role that nurses play in patient education and multidisciplinary communication. The faculty offered the following perspectives:

Management of geriatric patients with hematologic malignancies may be challenging, and dose modifications of different treatments may be required. The logistics of patient travel and the ability of the patient to tolerate different treatments may also influence treatment adherence. Polypharmacy is an obstacle to achieving patient outcomes that must be addressed, and nurses play a vital role in helping to overcome this and other obstacles through support, communication, and education.

Younger patients may also have challenges with treatment adherence, and education can help to improve patient insight into the nature of their hematologic malignancies and the need for treatment. Supportive organizations for younger patients are also available.

A multidisciplinary approach can help to optimize outcomes and facilitate patient engagement in the treatment decision-making process. Nurses can help to assess patient needs and manage anxiety related to treatment challenges. Open communication regarding potential adverse events associated with treatments should take place. There are multiple barriers to optimal patient adherence to treatments for hematologic malignancies, which must be recognized and addressed by clinicians.

There are validated assessment tools that can help to enhance management of patient symptoms. Severity of patient-reported symptoms may not correlate with those recorded by clinicians, and adherence to treatment commonly may decline over time. Patient socioeconomic factors, including cultural differences, also need to be addressed. There are several resources that are available to share with patients who are being treated for hematologic malignancies.